Solid Pseudopapillary Tumor of the Pancreas:a Case Report

Case Report Solid pseudopapillary tumors(SPT)of the pancreas are considered to be a rare low-grade malignancy that mainly appears in young women.It accounts for less than 1%of all pancreatic neoplasms and is pathologically distinctive from other types of pancreatic cancers.Curative resection is the optimal choice for SPT and the 5-year survival rate of SPT is about 95%.Here we report a case of a young girl who presented with this rare pancreatic tumor.     

Solid-pseudopapillary tumor of the pancreas: One case report and literatures review

Introduction
Solid-pseudopapillary tumor （SPT） is a very rare primary neoplasm of the pancreas. Franz first described it in 1959. It is usually seen in young females. In spite of possible histological findings of malignancy, SPPT typically shows a benign clinical course and a low malignant potential. The pathogenesis of these tumors is still controversial. It has been suggested that it might originate from ductal and acinar pancreatic cells, endocrine cells or pluripotential stem cells.     

Ileal Lymphangioma Presenting with Gastrointestinal Hemorrhage: A Case Report

Introduction Lymphangioma is a rare benign tumor of lymphatic vessel origin.The tumor often appears in the head and neck region at a young age and can occasionally be found in the abdomen of adults with protean degrees of symptoms depending on the tumor size and location. How-ever, lymphangioma of the small intestine is extremely rare with only a few cases reported in the literature. As the tumor is not well-recog-nized, many patients with small intestine lymphangioma have been given an incorrect preoperative diagnosis. The ideal treatment for the disease is surgical excision, and the prognosis is comparatively good.In this paper, we report a rare case of ileal lymphangioma with gas-trointestinal hemorrhage preoperatively diagnosed using enteroscopy and treated with surgery.     

Solid-Pseudopapillary Tumor of the Pancreas： One Case Report and Literatures Review

Introduction Solid-pseudopapillary tumor(SPT)is a very mre primary neoplasm of the pancreas.Franz first described it in 1959.It iS usually seen in young females.In spite of possible histological findings of malignancy,SPPT typically shows a benign clinical course and a low malignant potential.The pathogenesis of these tumors iS still controversial.It has been suggested that it might originate from ductal and acinar pancreatic cells,endocrine cells or pluripotential stem cells.     

Obstructive jaundice due to a rare periampullary tumor

Gangliocytic paraganglioma is a rare neuroendocrine tumor predominantly arising in the second part of the duodenum with rare local recurrence or metastasis to regional lymph nodes.A 92-year-old female presented with obstructive jaundice.On exam she had pale conjunctiva and icteric sclera.Abdominal examination revealed tenderness in the upper abdomen.Laboratory data was consistent with obstructive jaundice.Computed tomography of the abdomen revealed a dilated gall bladder and a common bile duct(CBD)with no evidence of liver lesions or pancreatic head mass.Endoscopic ultrasonography revealed a 1 cm isoechoic submucosal nodule at the periampullary area,dilated CBD(9 mm),a prominent pancreatic duct(4.1 mm)and a hydropic gall bladder with no stones.Endoscopic retrograde cholangiopancreaticography was performed to relieve obstruction and showed a 1 cm periampullary mass which underwent an en-bloc snare resection.Histopathology analyses with immunohistochemical stains were positive for cytokeratin,synaptophysin,S-100 protein,neuron specific enolase and negative for actin and desmin consistent with periampullary gangliocytic paraganglioma.Periampullary gangliocytic paraganglioma is a rare benign tumor of the small bowel.Common presentation includes abdominal pain and obstructive jaundice which should be included in differential diagnosis of obstructive jaundice.Endoscopic resection is a curative therapy in the absence of local invasion or distant metastasis.     

胰腺实性假乳头状瘤的临床特点及预后分析

Objective To study the clinicopathological and immunohistochemical features, histogenesis and biological behavior, clinical treatment and pronosis of solid pseudopapillary tumor of the pancreas ( SPT). Methods Routine HE and immunohistochemical (SP) stainings were used in the pathological examination of 18 cases of SPT. Their clinical data were retrospectively analyzed. All the 18 postoperative patients were followed-up for 3 months to 10 years with an average of 29.2 months.Results There were 16 females and 2 males, age ranging from 9 to 65 years with mean age of 25.3 years. Abdominal pain and palpable mass were among the major complains. Tumors were encapsulated and mixed with solid and cystic tissues. Histological features were pseudopapillary structure with a fibrovascular core. Immunhistologically, most tumors were positive for α-AT, α-ACT and Vim, with a high percentage of 94.4%. The eighteen cases were followed-up from 3 to 120 months. Five cases received reoperation after recurence, and 14 cases were alive. Maximum survival time was 121 months and the minimum survival time was 3 months, with a median survival time of 23.0 months. The 5-year survival rate was 72.2%. A Kaplan-Meier analysis revealed that patient's age,tumor size, pathologic features, metastasis were major prognostic factors for SPT. Conclusion SPT is a tumor of low-grade malignancy and may be derived from multipotent stem cells. SPT most frequently affects young female, and has distinct clinicopathologic manifestation with excellent prognosis after surgical treatment.     

胰腺实性假乳头状瘤的临床特点及预后分析

Objective To study the clinicopathological and immunohistochemical features, histogenesis and biological behavior, clinical treatment and pronosis of solid pseudopapillary tumor of the pancreas ( SPT). Methods Routine HE and immunohistochemical (SP) stainings were used in the pathological examination of 18 cases of SPT. Their clinical data were retrospectively analyzed. All the 18 postoperative patients were followed-up for 3 months to 10 years with an average of 29.2 months.Results There were 16 females and 2 males, age ranging from 9 to 65 years with mean age of 25.3 years. Abdominal pain and palpable mass were among the major complains. Tumors were encapsulated and mixed with solid and cystic tissues. Histological features were pseudopapillary structure with a fibrovascular core. Immunhistologically, most tumors were positive for α-AT, α-ACT and Vim, with a high percentage of 94.4%. The eighteen cases were followed-up from 3 to 120 months. Five cases received reoperation after recurence, and 14 cases were alive. Maximum survival time was 121 months and the minimum survival time was 3 months, with a median survival time of 23.0 months. The 5-year survival rate was 72.2%. A Kaplan-Meier analysis revealed that patient's age,tumor size, pathologic features, metastasis were major prognostic factors for SPT. Conclusion SPT is a tumor of low-grade malignancy and may be derived from multipotent stem cells. SPT most frequently affects young female, and has distinct clinicopathologic manifestation with excellent prognosis after surgical treatment.     

Pancreatic cancer–Neoadjuvant therapy

In spite of the high mortality in pancreatic cancer, significant progress is being made. This review discusses multimodality therapy for patients with pancreatic cancer. Surgical therapy currently offers the only potential monomodal cure for pancreatic adenocarcinoma. However only 10%–20% of patients present with tumors that are amenable to resection, and even after resection of localized cancers, long term survival is rare. The addition of chemoradiation therapy significantly increases median survival. To achieve long-term success in treating this disease it is therefore increasingly important to identify effective neoadjuvant/adjuvant multimodality therapies. Preoperative chemoradiation for potentially resectable pancreatic cancer has the following advantages: (1) neoadjuvant treatment would eliminate the delay of adjuvant treatment due to postoperative complications; (2) neoadjuvant treatment could avoid unnecessary surgery for patients with metastatic disease evident on restaging after neoadjuvant therapy; (3) downstaging after neoadjuvant therapy may increase the likelihood for negative surgical margins; and (4) neoadjuvant treatment could prevent peritoneal tumor cell implantation and dissemination caused during surgery. This review systematically summarizes the current status, controversies, and prospects of neoadjuvant treatment of pancreatic cancer.     

胰腺癌:新辅助治疗

In spite of the high mortality in pancreatic cancer, significant progress is being made. This review discusses multimodality therapy for patients with pancreatic cancer. Surgical therapy currently offers the only potential monomodal cure for pancreatic adenocarcinoma. However only 10%-20% of patients present with tumors that are amenable to resection, and even after resection of localized cancers, long term survival is rare. The addition of chemoradiation therapy significantly increases median survival. To achieve long-term success in treating this disease it is therefore increasingly important to identify effective neoadjuvant/adjuvant multimodality therapies. Preoperative chemoradiation for potentially resectable pancreatic cancer has the following advantages： （1） neoadjuvant treatment would eliminate the delay of adjuvant treatment due to postoperative complications; （2） neoadjuvant treatment could avoid unnecessary surgery for patients with metastatic disease evident on restaging after neoadjuvant therapy; （3） downstaging after neoadjuvant therapy may increase the likelihood for negative surgical margins; and （4） neoadjuvant treatment could prevent peritoneal tumor cell implantation and dissemination caused during surgery. This review systematically summarizes the current status, controversies, and prospects of neoadjuvant treatment of pancreatic cancer.     

胰腺癌:病理学

Introductions Pancreatic ductal adenocarcinoma （frequently simply being referred to as ＂pancreatic cancer＂） represents the most frequent neoplasm of the pancreas, accounting for 85% to 90% of all pancreatic tumors . According to the definition of the World Health Organization , it ＂probably arises from and is phenotypically similar to pancreatic duct epithelia, with mucin production and expression of a characteristic cytokeratin pattern＂.